CMS is encouraging providers to address the social determinants of health through data-driven efforts and new resources.
CMS is taking a data-driven approach to helping healthcare providers address the social determinants of health.
With targeted ICD-10 codes and deeper dives into Medicare and Medicaid data, the agency is hoping to bring more evidence-based insights into the challenging task of managing vulnerable populations at scale.
“Each April marks National Minority Health Month, providing the opportunity to acknowledge the progress made in reducing disparities, as well as a chance to reflect on what more needs to be done to achieve health equity,” wrote Cara V. James, PhD, director of the CMS Office of Minority Health in a recent blog post.
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The agency recognizes the critical role of non-clinical factors, such as food and housing security, loneliness, and educational attainment, in determining a patient’s capacity to access care and adhere to treatments.
“These factors affect access to care and health care utilization as well as outcomes. As we seek to foster innovation, rethink rural health, find solutions to the opioid epidemic, and continue to put patients first, we need to take into account social determinants of health and recognize their importance,” said James.
“Data collection will help us strengthen our understanding of the relationship between social determinants of health and health care use across diverse populations, allowing us to develop solutions and better connect patients to much needed services.”
CMS is approaching the complex problem from multiple fronts, including encouraging providers to take advantage of “Z-codes” in ICD-10.
These codes allow providers to create structured information about the social determinants of health, furthering the ability to analyze patterns and design impactful interventions.
The American Medical Association and UnitedHealthcare are working to expand the number and scope of available Z-codes, the two organizations announced early in April. Providers may soon have two dozen new options for recording information about socioeconomic challenges.
James also highlighted several other CMS initiatives to equip providers with strategies and resources to manage population health.
Organizations can leverage the Accountable Health Communities (AHC) social needs screening tool, the PREPARE tool from the National Association of Community Health Centers, or the Health Leads Screening Toolkit to better understand their patients’ challenges.
These quick assessments allow providers to have meaningful conversations with patients about their unique socioeconomic situations, and may help clinicians connect patients to community resources or services to improve their experiences.
In conjunction with these efforts, CMS is offering a deeper look into Medicare Advantage populations and the significantly different experiences of white patients versus those in other racial and ethnic groups.
Socioeconomic challenges are strongly correlated with racial and ethnic patterns, rendering it critically important to identify and address disparities along these lines.
In a new report produced with the RAND Corporation, CMS notes that non-white Medicare Advantage beneficiaries fare worse on many measures of clinical care and patient experience, including getting appointments quickly and receiving certain preventive services.
“Despite advances in health care access, increases in spending, and improvements in quality over the last decade, there is well-documented evidence that members of racial and ethnic minority groups continue to experience worse health outcomes,” CMS said in an accompanying FAQ sheet.
“To comprehensively address and eliminate health disparities, it is first necessary to be able to measure and publicly report – in a standardized and systematic way – the nature and extent of these differences.”
“This information may be useful for targeting quality improvement activities and resources, monitoring health and drug plan performance, and advancing the development of culturally appropriate quality improvement interventions and strategies.”
The detailed report shows that some ethnic and racial groups experience worse chronic disease management compared to white patients.
Hispanic and black patients are significantly less likely to have access to controller medications for asthma, for example. They are also less likely to have controlled blood pressure and receive comprehensive diabetes care.
Closing these gaps will require providers and CMS to work together to collect meaningful data and share insights across the care continuum.
The Office of Minority Health offers an online resource center for providers that includes patient-facing information in multiple languages and information about how to bring enhanced population health management into the community setting.
“Adequately and appropriately addressing social determinants of health will require the efforts of all stakeholders including beneficiaries, community groups, and health care providers,” James said.
Date: May 14, 2019
Source: Health IT Analytics
